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Non-Work Related Injuries can Impact a Worker’s Compensation Claim

  • Jon Koutcher
  • 07/15/2013

On July 12, 2013, the Pennsylvania Commonwealth Court, in SEPTA v WCAB(Cunningham), issued a decision affirming the principle that an employer does not have to prove job availability when an injured worker is disabled from all employment as a result of a non-worked related injury.  The facts of this case are relatively straightforward: a worker sustained a right knee injury working as a mechanic and had returned to work in a light duty capacity; about one month later the worker was involved in a car accident outside of work and injured his left knee, low back and left hand; then, the injured worker went out of work and had surgery to his work related, right knee injury and again returned back to light duty thereafter. About two years later, the worker was involved in another non -work related car accident, and again suffered injuries to his left knee, low back, and left hand, causing the worker to again stop working.

The employer filed a Petition to Modify/Suspend Compensation benefits based upon a labor market survey, alleging the worker could not respond to jobs open, available and within vocational abilities and physical restrictions solely due to injuries sustained in the non- work related car accident. The Worker’s Compensation Judge agreed and suspended benefits.  The Worker’s Compensation Appeal Board reversed, and an appeal to the Commonwealth Court ensued.  On appeal, the employer argued it was not required to establish job availability since the worker’s non-work related injuries rendered the worker totally disabled.  The Commonwealth Court agreed.

In general, to suspend benefits, the employer has the burden to establish that the injured worker has recovered all of his earning power. The employer must prove that the injured worker can return to employment and that a job the injured worker is capable of performing is available.  However, the employer does not have to prove job availability when the injured worker is totally disabled by a non-work related condition.  In Cunningham, the injured worker had injuries that essentially resolved to the point he could perform sedentary work but for his non-work related injuries. Requiring the employer to prove job availability under these circumstances would be unreasonable.

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